Association between thyroid disorders and abnormal uterine bleeding in reproductive ages

Authors

  • Aiyleen S. Shawl Department of Obstetrics and Gynecology, L. D. Hospital, Srinagar, Jammu and Kashmir, India
  • Massarat Naz Private Consultant, Obstetrics and Gynecology, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20203516

Keywords:

Abnormal uterine bleeding, Hypothyroidism, Hyperthyroidism, Menstrual cycle, Subclinical hypothyroidism, Thyroid disorders

Abstract

Background: Abnormal uterine bleeding (AUB) means any bleeding that is not normal in amount, duration, frequency, and cyclicity. It is a common disorder occurring in reproductive age group females. It can be understood as bleeding that occurs from the uterus outside the normal parameters and there are no structural defects in the genital tract. One of the most common associations with AUB is thyroid dysfunctions. Hence, this study aimed to see the incidence of thyroid-related disorders in AUB and also to assess the menstrual pattern.

Methods: A total 100 women suffering from AUB who presented to OPD of the gynecology department of L D Hospital Srinagar, Jammu and Kashmir were recruited in the study. All females in 19 to 45 years of age group with abnormal uterine bleeding were included excluding those with a previously known thyroid disorder, abortion history within 3 months, etc. Thyroid function tests were done in all along with ultrasonography of the pelvis region. Data were analyzed using SPSS software v.23.0. and Microsoft office 2007.

Results: The bleeding abnormality that was found in most of the women was heavy menstrual bleeding. Out of the 100 patients taken into study 11 had thyroid disorders, out of which subclinical hypothyroidism was most prevalent accounting for 8 cases, 2 cases were found to have hypothyroidism and 1 case of hyperthyroidism was detected.

Conclusions: Abnormal uterine bleeding has a strong association with thyroid disorders. The most common type of disorder is subclinical hypothyroidism. Thus, all patient of AUB must be evaluated for thyroid dysfunction.

References

Devi J, Aziz N. Study of histopathological pattern of endometrium in abnormal uterine bleeding in the age group 40-60 years. A study of 500 cases. Int J Med Sci Clinic Invent. 2014;1:579-85.

Padubidri VG, Daftary SN. AUB. In: Padubidri VG, Daftary SN, eds. Shaw’s Textbook of Gynecology. 16th ed. USA: Elsevier Health Sciences; 2015:335-348.

Munro MG, Critchley HO, Fraser IS. The FIGO systems for nomenclature and classification of causes of abnormal uterine bleeding in the reproductive years: who needs them? Am J Obstet Gynecol. 2012;207(4):259-65.

Hassan FF. The Frequency of histopathological patterns in endometriam obtained from a sample of iraqi women with abnormal uterine bleeding. Karbala J Med. 2017;10(3):3846-56.

Ajmani NS, Sarbhai V, Yadav N, Paul M, Ahmad A, Ajmani AK. Role of thyroid dysfunction in patients with menstrual disorders in tertiary care center of walled city of Delhi. J Obstet Gynaecol India. 2016;66(2):115-9.

Faisal AH. Study of thyroid hormones among female Iraqi thyroid disorders. In The 2nd Annual Int Conf Northeast Pharma Res Thailand. 2010;2:250-5.

Pahwa S, Gupta S, Kaur J. Thyroid dysfunction in dysfunctional uterine bleeding. J Adv Res Med Sci. 2013:5(1):78-83.

Bhavani N, Sathineedi A, GiriA, Chippa S, Reddy VSP. A study of correlation between abnormal uterine bleeding and thyroid dysfunction. J Recent Trends Sci Technol. 2015;14(1):131-5.

Byna P, Siddula S, Kolli S, Shaik MV. Thyroid abnormality in perimenopausal women with abnormal uterine bleeding. Int J Res Med Sci. 2015;3(11):3250-3.

Mansourian AR. Female reproductive physiology adversely manipulated by thyroid disorders: A review of literature. Pak J Biol Sci. 2013;16(3):112-20.

Sharma N, Sharma A. Thyroid profile in menstrual disorders. JK Sci. 2012;14(1):14-7.

Al-Naffii KO, Nasseralah CABM HAA, Al-Hillali KA, Ali AFM. Hypothyroidism in adults early clinical presentation in relation to age. Karbala J Med. 2008;2(3):352-6.

Al-Bustany DA. Clinical study of cases with hyperthyroidism in Erbil Governorate, Kurdistan Region-Iraq. Zanco J Med Sci. 2011;15(1):6-12.

Liu Z, Doan QV, Blumenthal P, Dubois RW. A systematic review evaluating health related quality of life, work impairment and health care costs and its utilization in abnormal uterine bleeding. Value Health. 2007;10(3):183-94.

Deshmukh PY, Boricha BG, Pandey A. The association of thyroid disorders with abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2015;4(3):701-8.

Schrager S. Abnormal uterine bleeding associated with hormonal contraception. Am Fam Physician. 2002;65(10):2073-80.

Attia AH, Youssef D, Hassan N, El-Meligui M, Kamal M, Al-Inany H, et al. Subclinical hyperthyroidism as a potential factor for dysfunctional uterine bleeding. Gynecol Endocrinol. 2007;23(2):65-8.

Kang JH, Kueck AS, Stevens R, Curhan G, Vivo DI, Alexander E, et al. A large cohort study of hypothyroidism and hyperthyroidism in relation to gynecologic Cancers. Obstet Gynecol Int. 2013;743721.

Fraser IS, Critchley HO, Broder M, Munro MG. The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. Semin Reprod Med. 2011;29(5):383-90.

Muttappallymyalil J, Sreedharan J, Al Biate MA, Mummigatti K, Shantakumari N. Prolactin level in women with abnormal uterine bleeding visiting department of obstetrics and gynecology in a university teaching hospital in Ajman, UAE. Gulf Med J. 2014;3(S2):S91-8.

Marimuthu K, Loganathan M. Influence of thyroid gland in women with abnormal uterine bleeding in reproductive age group. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2222-5.

Mohan S, Page LM, Higham JM. Diagnosis of abnormal uterine bleeding. Best Pract Res Clin Obstet Gynaecol. 2007;21(6):891-903.

Gulab K, Monika S, Nidhi S, Rinki H, Rahul K, Juber A. Hypothyroidism-a risk factor for menstrual disorders among nulliparous females. IOSR J Dent Med Sci. 2015;14(12):78-81.

Mohapatra S, Behera SK. Prevalence of hypothyroidism in patients with provisional diagnosis of DUB. IJOG. 2017;3(1):23-9.

Parveen M, Kumari S, Haque SS, Kumar R. Evaluation of thyroid profile status in women with abnormal uterine bleeding in north Indian population. Int J Biomed Adv Res. 2017;8(7):288-91.

Al Shahrani AS, El-Metwally A, Al-Surimi K, Salih SB, Saleh Y. The epidemiology of thyroid diseases in the Arab world: a systematic review. J Public Health Epidemiol. 2016;8(2):17-26.

Jawzali JI. Regional differences of drinking water iodine and its association with thyroid disorder and serum iodine. Med J Babylon. 2017;14(1):198-208.

Vinita S, Ashwini SN. Impact of thyroid disorders on menstrual function. Fogsi Focus. 2006;1:30-1.

Verma SK, Pal A, Jaswal S. A study of thyroid dysfunction in dysfunctional uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2017;6(5):2035-9.

Al-Hakeim HK, Jassim WE, Ali IA. Prevalence of endocrine disorders among iraqi women with menstrual disturbances. Karbala J Med. 2010;3(3):889-96.

Maria JD, Jayakumari S, Sundaram PS. A Prospective study on hypothyroidism in premenopausal women. Int J Pharm Sci Rev Res. 2016;39(1):183-7.

Pushpa S, BikhaRam D, Razia MA, ZulfiquarAli SS, Tarachand D, Ishrat B. Impaired thyroid functions in patients with menstrual disturbances (An experience of a private clinic). World Appl Sci J. 2009;7(4):538-42.

Whitaker L, Critchley HOD. Abnormal uterine bleeding. Best Pract Res Clin Obstet Gynaecol. 2016;34:44-65.

Downloads

Published

2020-08-27

Issue

Section

Original Research Articles